Longstanding Fears Help Explain the Latest Wave of Obamacare Outrage

Health and Human Services Secretary Kathleen Sebelius gestures while testifying on Capitol Hill in Washington, Wednesday, Oct. 30, 2013, before the House Energy and Commerce Committee hearing on the difficulties plaguing the implementation of the Affordable Care Act.

Losing health insurance has long been a terrifying possibility for Americans who buy coverage on the open market. Historically, it meant taking on all kinds of risks, from forgoing needed medical care to financial ruin in the event of a serious illness or injury. Perhaps the greatest worry for those thrown off insurance policies was that they could not find good replacement coverage. According a study by the Commonwealth Fund, 57% of all Americans shopping for coverage in the individual insurance market in 2009 said they found it “very difficult or impossible” to find affordable insurance plans.

The fear of just such a dead end is no doubt part of what’s fueling a wave of panic among those opening their mailboxes this fall to find letters from insurers explaining that their plans are ending thanks to the Affordable Care Act. In news story after news story, consumers who purchased policies in the individual insurance market have expressed confusion as their lives are seemingly upended by Obamacare.

There have also been more than a few flashes of anger, mainly at the fact that President Obama promised repeatedly before the Affordable Care Act become law, “If you like your health care plan, you can keep your health care plan.” This pledge has not turned out to be true. The law outlaws all but a small percentage of “grandfathered” individual insurance policies and requires carriers to instead offer coverage that’s more comprehensive.

When the very people a law is supposed to help become angry, something has gone wrong along the way. In hindsight, Obama made a promise he could not keep, even if he wanted to. Liking one’s insurance policy was never enough to ensure it would continue indefinitely. Insurers, especially in the individual market, cancel and change policies regularly year to year.

Part of what’s being lost in the tumult over the President’s dishonest statement to the American people is the context in which he uttered it. In the months leading up to the March 2010 passage of the Affordable Care Act, a firestorm of misleading criticism and outright lies swirled around the effort. Republican critics told the public that the law would destroy Medicare, even though it cut only about 10% of the program’s funding. They also said it would allow the federal government to withhold life-saving medical care for seniors, a deception made up basically out of thin air. Obamacare was labeled a “government takeover of health care,” even though the law preserved both the private insurance system and the private health care system, albeit with greater regulation.

In short, there was a lot of confusion and panic back then too. And it was fueled by charges that Obamacare would hurt all Americans directly and profoundly. When Obama told the public, “If you like your health care plan, you can keep your health care plan,” he was trying to counter this narrative, especially for the 80% of Americans who get coverage through their jobs, Medicare or Medicaid and who were concerned about the coming changes. Insurance for these people will continue largely unaffected by Obamacare, although not completely. (In 2018, an Obamacare tax on high-cost insurance plans could cause upheaval in that part of the market as well.)

But Obama never really qualified or narrowed his “keep it” statement. He explained that the law would improve options for those buying coverage in the independent market, but his pledge made it seem like these people could choose to participate in the new system or stay in the old one, when the law was designed to gradually eliminate the old system altogether. Some plans that haven’t changed since 2010 are grandfathered and free of new Obamacare regulations, but, says former president of the National Association of Insurance Commissioners Sandy Praeger, “I think eventually all of them will change.” So far, the reforms that the law sought to bring—whether Obama was honest about their implications or not—are falling into place exactly as planned. Many insurers are ending policies that do not comply with the law, and pitching new policies that don’t discriminate based on health status, cover a comprehensive list of benefits and limit how much consumers will have to spend out of pocket. In some cases, these new plans will cost consumers more. For others, the better coverage will cost the same or less.

Yet, the specter of suddenly becoming uninsured and forced into an unstable and unpredictable situation remains. And it is likely to remain for a while. “Some of this brouhaha is based on this old paradigm where if you got dropped you couldn’t find something else,” says Praeger.

This lingering fear is understandable. The Affordable Care Act’s new system of subsidies and competition between carriers through online insurance marketplaces is new and untested. Complicating this is the fact that many of the web sites operating these marketplaces, including a federal one responsible for individual market enrollment in 36 states, are not functioning well or at all. If you lose something you depended on, and “liked,” and you don’t have access to anything better to replace it, what is there to do besides worry—or even panic?

I keep wondering if the President, members of Congress, or
any of the journalists commenting on the subject have paid for their own
health insurance in recent years (or even have any idea how much it costs). My family of 4 has been paying $14,000 for
what the President refers to as a “cut-rate”, “low cost” policy that is being
terminated at year end as part of the “Affordable” Care Act. As we “shop around” as the President advises
we find prices for comparable coverage in 2014 ranging from $28,000 to $32,000
annually. Add that to federal and state
income tax, and local property tax, sales tax and auto insurance that we are
required to carry, and you have to wonder if the middle class small business person can exist in the future.

I get it. It's all the Republicans fault for FORCING Obama to make up lies in order to counter their lies. Brilliant. I'm curious, did you bend over this far backwards to excuse Bush's lies about WMDs? Your back must really hurt.

But let's forget that for now. Most of the people who are having their plans cancelled are being force to pay premiums that are twice as high, or get worse coverage. Was that the plan? I thought ObamaCare was supposed to improve their benefits, not force them to downgrade their coverage. Oh, but they are the "losers". Just middle-class healthy people who have to be thrown under the bus to extend coverage to the poor. You have to break a few eggs to make an omelette.

Especially the poor with substance abuse and mental health problems. No out of network coverage, but at least they get rehab. So when that healthy middle-class person needs to see an out-of-network specialist for back problems, that's on his dime, but it's all good, because he's helping that heroin addict get free rehab. Isn't "sharing" great?

The goodwill Obama and Democrats had is evaporating under
the false promise of the ACA by cancelling, state tax commission approved,
affordable healthcare policies. Rural exchange policies are unaffordable
being two to three times more expensive than urban policies. Democrats should
work quickly to grandfather existing policies to take this issue off the table
or face two election cycles of "they lied."

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In other news, how can Sen. Leahy just stand there as the GOP Congress subverts the express intent of our Founding Fathers' prescribed duties over what, exactly? Alleged "partisan differences"? That the President refuses to honor your Unconstitutional Legislative Veto request to "defund" the ACA? Uh, should members of the bar just "forget" our rule of law PRECLUDES such State Action [see, e.g., INS v Chadha (1982) 462 U.S. 919]? Above all, there is NO LEGAL AUTHORITY that gives ANY member of the Senate any self-perceived discretion to subvert the "Advice and Consent" function of the Senate- not over some fabricated Benghazi hearing/red herring, much less the "will of money donors". Why pretend that our National Security interests are "served" by "shutting down" the government only to, what, "reopen" it and "refuse" to honor the express requirements of your offices? You are all SERVANTS of the People. Let's hope Sen. Leahy honors Procedural Due Process rights on our behalf by upholding the law, by rebuking those that subvert its plain meaning- not merely via overt dilatory tactics and obstructionist conduct- but "openly questioning" the rule of law itself. How was the “shut down”- or just the subversion of the "Appointment Power" not a deprivation of Procedural Due Process if it is undisputed under our laws that the Due Process Clause was intended to secure an individual from an abuse of power by government officials? Daniels v. Williams (1986) 474 U.S. 327.

And thus we have the Law of Unintended Consequences fueled by an irresponsible legislative act (we have to pass it to find out what's in it!) and outright lies (think Death Panels) designed to scare, not inform.

Under the current environment of lies, distortion, spin, political dysfunction and partisan politics it's no wonder we have a cluster f**k called Obamacare.

Do you have coverage through your employer? You are very likely to be in
the same boat as these individual market participants next year when
the business mandate kicks in. Why? How's your arithmetic? If (as a
business owner) you could pay a $2000 penalty per employee instead of,
let's say, 40% of a $18,000 annual group policy for an employee, what
would you do? Probably pay the penalty and give some $$ (though less
than [(.40 x 18000)-2000] to the employee to let them "shop around" in
the exchanges. So unless you can negotiate the terms of your employment you should prepare to be an
exchange participant next year.

The author fails to point out another side effect of the law when talking about people who currently get their health insurance through their employers. That 80% figure is going to come down as employers decide it's cheaper to pay the penalty than cover health benefits. IBM, Time Warner, Walgreens and Home Depot have already announced this decision.

I do not hold President Obama responsible for the fact that my present health insurance company sent me a letter last week notifying me that as of January 1, 2014 I would not be covered by that company. President Obama did not take out a piece of insurance company stationery, compose that letter, stamp it and mail it to my address. It was my insurance company. The reason that I am being dropped is that they do not want to cover me under my existing policy for the basics included in the ACA for the same premium. Of course, when I called the insurance company for clarification, a sales rep was eager to apologize and transfer my call to the new policy department. That was so that I could buy a new policy with all the components of ACA for a higher premium because the policy that I was being offered would have to take into account my pre-existing conditions.

Well, I am headed for the Healthcare Exchange. I do not care about the website glitches, or the long waits, or the identity verification that is hanging in limbo. I may submit an application in an office or on-line, but I am not blaming President Obama for believing that the insurance industry would accept the changes in coverage as mandated by ACA and NOT drop its customers wholesale.

By the way, I am not a Republican nor a liberal, just a retiree younger than 65.

@SpaceVixenKlein And that's bad because heroin addicts are only heroin addicts because that's what they choose to be...just like gay people, and poor people. If only everyone would just choose to be hard working, straight white people, this country could be great again.

@AlphaJuliette The cluster f**k of Obamacare is law because Republicans in the Senate filibustered every other option, including one that covered everyone that needed coverage, had no mandate involved, was paid for by closing tax loopholes and partially returning the tax rate on the wealthiest 10% to what it was before Bush lowered it, and was supported by 65% of the country.

@bryanfred1 "IBM, Time Warner, Walgreens and Home Depot have already announced this decision."

No they haven't. They're cutting spousal benefits and insurance
for part-time workers and retirees. And why blame a program that was
built to provide insurance to the uninsured? Those companies are solely
to blame for their decisions.

"None of the moves was dictated by the health-care law.
All, though, have occurred in an environment shaped by Obamacare, which
has pushed businesses and governments to reexamine their health-care
role as costs soar and national priorities shift. The act now is giving
businesses cover to loosen the decades-old link between jobs and health
insurance, a shift that may further cloud the outlook for an already
unpopular law."

You might also look to the up-side. One of the big disadvantages for US business in international markets is having to pay for employee health insurance, which is largely paid for by the government (I.e., the taxpayers) of their foreign competitors. The further we go toward a universal system where risk and cost is spread as widely as possible, the better. The unexpected consequences we're experiencing only highlight that the ACA doesn't go far enough and is exactly what liberals warned about when Republicans came up with this solution and when Democrats implemented it.

@seizeabe That was the responses this charade is intended to induce and would be one of the worst thing to happen to civil liberties in the last century. The idea behind the American system isn't to guarantee everything just guarantee the opportunity.

@seizeabe The trouble there is that the oligarchs who determine what sort of health care system we have, long ago, replaced any greater moral sense of right and wrong with mere fiduciary responsibility.

@oldtimer The Obama Adminsitration (HHS) made sure to write the regulations as narrowly as possible so that very few plans would be grandfathered in. That was a deliberate choice. The realtively health have to be forced to pay more to keep costs down for all the sick people who will be entering the system.

Don't be surprised if your premiums double on the exchange. i hear that is very common.

@oldtimer Of course the premium on the new policy is higher - the coverage is far more broad, which means the insurance company's costs are going to go up and be passed to you. The problem is you can no longer buy the type of policy you want - just the one the government says.

We need Medicare for all. It may take a number of years to implement, but right now there isn't the will or courage in DC to buck the special interests. Obama can be blamed for letting big pharma and the insurance companies participate in writing the law. I'm beyong blaming the GOP. They are so "out to lunch" that they don't belong in any rational discussion about healthcare. The best thing they can do is just get the f**k out of the way.

@ok2judgeI used to be able to get insurance without Maternity, newborn care and pediatric services at a reduced rate. Now I have to find a much more expensive plan that provides services I have no use or need for because the government wants me to waste my money. They feel they are entitled to in this case make me basically buy hurricane insurance in Arizona.

@ok2judge Yeah, because only Republicans buy individual insurance. What on earth are you talking about? The people complaining are the ones who are losing or can no longer afford their coverage, and feel betrayed by their own President.

@barneydidit@SpaceVixenKlein Your so right. Nobody chooses to be a heroin addict, therefore they shouldn't have to pay for their own rehab. Otherwise healthy people should pay twice as much for insurance in order to help them. This must be mandated by law.

The irresponsibility continues to this day and shows no sign of abating. So, basically, right now, everything coming out of D.C. is a cluster f**k. See the continuing budget debate sideshow. (side show because it is no longer a crisis therefore not covered by the media. Stay tuned.)

@shepherdwong -- The program was also built to use insurance companies to "spread the wealth around".... It isn't insurance but a system that forces people to "buy" products they don't want in order to take their money to subsidize other people so that they can get "affordable insurance". In other words the ACA takes from the working middle-middle class, young and healthy in order to give, well, people who aren't so young or healthy and the lower-middle class. Spread the wealth, baby!

@shepherdwong The program was never built to insure the uninsured, it was sold as a program to do just that. It was built however to cut down on the 14% of gdp that is now spent by the government on medicare and medicaid. The idea was to force many healthy and currently uninsured into the pool, by requiring by law they carry insurance to reduce the rates that the government pays toward the services they provide. the Affordable Care Act is projected to save the federal government $190 billion over the next 10 years, while citizens are left with much higher deductibles and required to carry coverage for things like maternity that they might not find applicable.

@ChristopherWeingart@seizeabe Wait...America is supposed to guarantee me the opportunity to allow me to reach the economic success necessary to allow me to see a doctor if I need to?...and yet if I was unfortunate enough prior to Obamacare to have a pre-existing condition, any economic success less than top 10% in the country would have still not allowed me to obtain insurance. Conservatives keep forgetting about that little hitch in their logic.

@ChristopherWeingart@seizeabe "Guarantee the Opportunity!" Absolutely correct! THAT should be the business of government; to keep the playing field level and fair. But it hasn't done that.

Witness the erosion of the Middle Class. It is fast becoming the 47%'ers who already need and will need government assistance. Witness the increasing Wealth Inequality where a smaller number of people own the vast majority of wealth in this country. Witness the new Labor Market where educated, qualified and experiences people simply cannot find a job and tend to drop out.

@bryanfred1"The problem is you can no longer buy the type of policy you want - just the one the government says."

Well, guess what: you can't buy a car without seat belts either. Get over it. In fact, if you're dumb enough to want to pay premiums to companies that are happy to take your money for junk insurance that won't cover you when you need it, wise up.

@tommyudo@oldtimer The GOP have pretty much been out of the way the whole time and look what has happened. The dems passed it, the dems built it and the dems are trying to implement it. The funding for the ACA was contained in the original bill, so don't try the phony line about GOP's attempts at defunding. The GOP has been the only party to propose tort reform, which has been shown to be indisputably a step in the right direction. Obama is squarely in the pockets of special interests. If you don't thinks so, then you the one who's "out to lunch".

@ChristopherWeingart@ok2judge Exactly. They need you to pay more to help cover other people's health care costs. Everyone pays the same rate, right? The relatively healthy subsidize the sick. Men subsidize women. The healthy middle class subsidizes drug addicts and the mentally ill, and helps pay for dental care for poor people's kids, and maternity for single mothers. That's what "insurance" means to a Democrat. "Insurance" = "sharing".

@barneydidit I agree that passing of O'Care got the discussion going. I find it funny that those who are so afraid that the government is going to control your healthcare are not so afraid of private industry doing it when their bottom line is the Almighty Dollar and not your care.

Absolutely agree that something had to be done. No doubt about it. But I'm finding that the very aspect of controlling the upward spiraling costs of healthcare insurance that was one of the cornerstones of the ACA has led to exorbitantly more expensive coverage.

@AlphaJuliette@barneydidit It's a toss-up though as far as which would have been more irresponsible- passing Obamacare, or leaving things at status quo. One can argue that even with all the drawbacks to Obamacare, it got us out of the "we have the best healthcare system in the world (despite how poorly we rank in virtually every metric used to measure healthcare worldwide)" mindset that always won out prior to 2009.

@ChristopherWeingart"[T]he Affordable Care Act is projected to save the
federal government $190 billion over the next 10 years, while citizens
are left with much higher deductibles and required to carry coverage for
things like maternity that they might not find applicable."

You say that like it's a bad thing and that "the government" isn't the taxpayers who pay for it. Idiotic. The young "invincibles" who drive too fast while drinking too much bear as much responsibility as their parents on statins. No free rides.

"This is one of the cheapest shots against Obamacare, and is probably adequately addressed by pointing out that while men do not get pregnant,
they are the ones that get women pregnant, and therefore should have to
pay part of the cost. After all, the law already recognizes men's
responsibility to the product of a pregnancy, in that it requires men
who do not share directly in the cost of raising their children to make
childcare payments. Call the maternity care portion of men's health
insurance liability insurance, if you will - in the same way your car's
liability insurance helps pay for the cost of your actions."

You guys are so predictable. I don't like your viagra and your drunk driving, but I pay through insurance for it. There's a reason the GOP only has a 22% approval rating, and it's due to sound bites like yours.

@MikePalmerIt is simply the fact that the government is substituting its judgement for each individual consumer, which is something that history has shown time and again is a recipe for failure.

Apparently you misunderstood sheperdwong's comment. The government, whether local, state or federal substitutes its authority over many aspects of your life on what you can and cannot do with many laws.

Insurance coverage being one of the most prevalent causes of said laws.

@shepherdwong @bryanfred1 Shepherd: in your prodigious consumption of the ACA kool aide, you miss the point entirely. It is simply the fact that the government is substituting its judgement for each individual consumer, which is something that history has shown time and again is a recipe for failure Many people out there were happy with their policies and didn't believe that they were "junk", as you so cavalierly describe them. Your analogy about seat belts is entirely misplaced as well. Basic elements of coverage is not what what's at issue in these new regulations. Its a whole host of coverages that many people simply do not want or need. A better comparison would be if the government were to suddenly come out and mandate that auto insurance cover car washes, oil changes, wiper fluid and tire rotations, and then try to tell people who only had and only wanted collision insurance that these new policies are much better b/c they covered a whole lot more and their old ones were "junk"-- irrespective of the fact that they are 2 or 3 more times as expensive. Get your head out of your a**.

@shepherdwong You buy the policy that you need and not the one the government forces you to buy. I don't need a policy that pays for hormone therapy, reconstructive surgery and other types of therapy for a sex change and I shouldn't have to pay for others to obtain those benefits. Insurance was meant to cover medically necessary procedures!

Also, regarding your seat belt analogy, you are wrong, you can buy a classic car that doesn't have nor require seat belts. I personally wouldn't like to drive one without seat belts but the point is that your analogy was flawed and you only made it because you believe that people are too dumb to make their own decisions and that the Government should make them for us. Maybe you have a point! Look who is President...